Understanding the OIG’s List of Excluded Individuals/Entities

Posted by Frank Strafford on October 27, 2014 in EPLS, Exclusion Screening, Exclusions, GSA, Healthcare HR,

Understanding the OIG’s List of Excluded Individuals/EntitiesIn order to protect Federal healthcare systems from unscrupulous employees and contractors, the Office of the Inspector General regularly updates a List of Excluded Individuals/Entities (LEIE) to help human resources departments streamline OIG screening processes.

Federal health programs, including but not limited to Medicare and Medicaid, will not pay for services or products provided by OIG excluded individuals. They may also cut off funding to organizations that employ or contract individuals on the OIG exclusion list.

So how does someone end up on this list, and can they get off it once they’ve been excluded?

Mandatory Exclusions
There are several instances in which the OIG is required to exclude an individual. These include convictions for crimes related to a healthcare program or to patient abuse and neglect. An individual must also be excluded if they are convicted of a felony related to health care fraud or misuse of a controlled substance. Any one of these exclusions comes with a minimum of five years on the OIG exclusion list. Two will result in a minimum of 10 years, and three or more results in permanent exclusion.

Permissive Exclusions
Permissive inclusions are more flexible, and are generally issued at the judgement of the OIG. A misdemeanor conviction of healthcare fraud, or general fraud, can result in an exclusion term of three years or more. Misdemeanors convictions granted for obstruction of an investigation or controlled substance abuse can also result in three years or more on the list. License revocation or suspension, kickbacks, and various other offenses associated with job performance and prohibited activities will land individuals on the exclusion list for more flexible terms.

Can OIG Excluded Individuals get off the LEIE and SAM Exclusion Checks List?
An individual has to apply for reinstatement to be removed from the OIG exclusion list, regardless of the term of their exclusion. Unfortunately, applying for reinstatement through the OIG will not result in reinstatement through other excluding bodies. The process for OIG excluded individuals to get off the OIG list is complex, so it’s best to avoid ending up there at all.

To learn more about Exclusion Screening, visit our OFFICE OF THE INSPECTOR GENERAL OIG EXCLUSION LIST REQUIREMENTS page.

About Frank Strafford

About Frank Strafford

Related Articles

Nursing Licensure Verification & Credentialing

April 27, 2021

It goes without saying that nursing licensure verification is a benefit to all stakeholders in our healthcare ecosystem.  Our licensing system allows patients to be satisfied that nursing profess...

CMS Preclusion vs OIG Exclusion

February 8, 2021

On January 1, 2019, the Centers for Medicare & Medicaid Services (CMS) introduced a new tool for Medicare plans – the CMS Preclusion List.  A previous article posted in 2018 provides an exc...

Appealing an OIG Exclusion

June 21, 2021

Every year, hundreds of health care providers and entities receive notification from the HHS OIG that they are being considered for exclusion from participation in federal programs. To date in 2021, 6...

Understanding OIG Exclusions

OIG Exclusions Screening Process

Exclusion FAQS

Quick OIG Exclusion Basics

Employing Excluded Individuals

Consequences to Employing an Excluded Individual

OIG Compliance Law

Laws and Publications on OIG Compliance

More Compliance Resources

About Us

Industry leader Streamline Verify has been forging new paths in Exclusion Screening.

Trusted for Good Reason

  • ✓ Guaranteed accurate
  • ✓ Certified Secure
  • ✓ Audit Proof
  • ✓ Feature-rich reporting
  • ✓ Round the clock real-time-data
  • ✓ Processing fully automated

Security First

  • ✓ Cloud hosted
  • ✓ Encrypted data
  • ✓ Real-time backups

Trusted for Accuracy

  • ✓ Physical security
  • ✓ Restricted access
  • ✓ Single sign-on
  • ✓ Password security
  • ✓ Certified secure
  • ✓ Cross checking

HEALTHCARE ESTABLISHMENTS NATIONWIDE COUNT ON STREAMLINE VERIFY

5

60%

Average workload reduction by implementing the Streamline Verify program

5

10K

Establishments trust Streamline Verify nationwide

5

2011

Serving the healthcare industry’s unique compliance needs since 2011

5

24X

Setting standards with hourly synchronization to primary source data

[class^="wpforms-"]
[class^="wpforms-"]